Election results could revive health care compact fight in Kansas

The 2016 election could revive a fight over Kansas’ commitment to a proposal that would give states control over federal health care dollars.

Gov. Sam Brownback signed a bill in 2014 that committed the state to a proposed health care compact.

The proposal, which supporters framed as a way to free the state from the requirements of the Affordable Care Act, would allow states to receive federal health care dollars as a block grant and to make their own decisions about how to spend that money.

Opponents, such as the AARP, warn that would empower the state to make changes to Medicare, the federal program that provides health coverage to seniors.

Interstate compacts are agreements between states that can go into effect after being approved by Congress and the president. Kansas was one of nine states to pass the health care compact legislation.

Bills to enact the compact failed to gain traction Congress in the years since Kansas passed the legislation – and it was extremely unlikely that President Obama would approve the legislation even if it had passed Congress.

However, after the election of Republican Donald Trump as president and Republican majorities in both houses of Congress, opponents and supporters are both contemplating the possibility that the theoretical compact could become a reality.

U.S. Sen. James Lankford, R-Okla., introduced a compact bill in 2015. His spokeswoman, Aly Beley, said in an e-mail that “Lankford looks forward to exploring the best way to replace Obamacare by working with the White House and Congress at the start of the new year.”　

Beley, who previously served as aide to Kansas Senate President Susan Wagle, said that the compact would allow “each state to manage health care for its citizens or join with other states to do so.”

Kansas House Minority Leader Jim Ward, D-Wichita, said that he expects the compact idea to receive serious consideration and debate in Washington.

“And that’s really scary,” said Ward, pointing to the potential impact to Medicare.

Ward said he plans to bring a bill to repeal Kansas’ commitment to the policy. He made an unsuccessful attempt at repeal last session, but after moderates and Democrats made gains in the Legislature this election Ward’s chances of withdrawing the state from the compact have likely improved.

Maren Turner, the director of AARP Kansas, said the organization – which advocates for seniors – remains strongly opposed to enacting a compact.

“Why risk the health of Kansans for something that has not really been thought through?” Turner said.

“There are a lot of questions about how the health care compact would work. Who would be responsible for the Medicare funding? If a person moved outside of one of the states within the health care compact, how would that work?”

When Brownback signed the compact legislation in 2014, he promised that he would protect Medicare from any cuts if the state took over control of the program. His office reiterated that stance this month.

“As Governor Brownback promised at the time, he will oppose any efforts at the state level to reduce Medicare benefits or coverage for Kansas seniors,” said Melika Willoughby, the governor’s spokeswoman.

Ward isn’t willing to take the governor at his word on the matter.

“Distrust is not strong enough. I don’t believe him one bit,” he said.

Turner, of AARP, said it’s not worth risking state control of Medicare regardless of the governor’s promises because of the number of unknowns.

“To come up with a health care compact that has way more questions than answers, that threatens to undermine the guaranteed benefit, that’s not a good idea,” she said.

This story was originally published December 29, 2016 at 3:22 PM with the headline "Election results could revive health care compact fight in Kansas."